A single transcutaneous injection of Dysport is safe and effective for treatment of lid retraction due to TED. Minor complications such as ptosis and diplopia may occur, however, this modality may offer temporary relief for patients with dysthyroid lid retraction awaiting orbital decompression or strabismus surgery or both.

Benign reactive lymphoid hyperplasia should be considered in the differential diagnosis of mass lesions of the caruncle and plica semilunaris, especially in young male patients. Histopathologic evaluation and immunohistochemistry studies are necessary to exclude lymphoma and other malignant lesions. Complete surgical excision of the plica or caruncle does not seem to induce significant complications.

Direct sling of the upper tarsus to the frontalis muscle without creation of flap is an effective procedure for correction of ptosis in patients with weak levator function. Minimal dissection and preservation of the orbicularis oculi prevents lagophthalmus and its consequences.